Brain and Mental Health: Meditation, Parity

Mental Health and the Brain:
A Discussion
Fall, 2008

 

Meditation, Parity

Our eleventh session and resulting on-line forum discussion moved beyond mental health syndromes to some broader contexts - adolescence and attachment theory, viewed again through the lens of asking whether thinking in terms of the brain can help defragment thinking and practice in the arena of mental health generally. This week we move on to exploring some additional broader contexts from the same perspective.

Readings for this week

Meditation
See below

Parity

Relevant materials elsewhere

Where we've been

It seems to me that it is impossible to come up with one universal definition, and that maybe the definition of mental health changes with each person. Maybe instead of defining mental health we need to be educating doctors to spend more time communicating with their patients and let the patient define the issue, not the doctor. While obviously this would create many problems within our health system as it is now, it seems to me the best solution for respecting each person's unique mental health experience. Maybe if we focus on changing the system we will be more able to define mental health as our perspective on it changes ... Paige Safyer

I also believe that it is impossible to come up with a universal definition of mental health. People differ from one another in their intelligence, desires, feelings and behaviors, in their views of themselves and the others, and in their views of the world and the future. We cannot just categorize the differences among people without considering how the different parts of each person come together to make that person who she/he is ... vpizzini

Health, either bodily or mental, is best described as an activity and not a static state of being in a particular disposition or orientation. I think our discussion thus far has led us to that fact, unambiguously. But, the path we have taken to get there has diverged into the “teakettle people” and the “no teakettle people”. That difference does color the meaning of our definition as health as an activity ... MartinBayer

We can NEVER think of people outside some frame of reference, some normative reality. To strive to do so may be to free ourselves from one kind of tea kettle reality, but at the same time it is merely adopting another one ... To be able to realize that what one previously believed was limited and normative, and to adopt a new view of the world – which itself will be limited of course – seems an excellent goal to strive for ... kmanning

being a good mental health practictioner means just that: thinking about each person in his or her own way, and treating each as such. It is also about increasing a person's own ability to make choices ... ysilverman

Maybe we should operate on the premise that everyone needs “help.” If there were consensus that everyone has the potential to be a “better” version of oneself than some of the stigma associated with experiencing distressing mental states and seeking help would dissipate. If mental health is not static, but a process of a ever-refining one’s story, so as to maximize one’s potential then the necessity of reducing a person to her behavior, her symptoms, her “limitations” would cease to be relevant and each of us would be less inhibited in the process of honing our skill sets, coming up with a “tool kit” of sorts that is tailored to our individual genes, our individual experiences ... Sophie F

A human life can be considered an artwork or a series of artworks. The artist is the human living a particular life, creating a unique work of piece. This piece is based on the person’s own experiences, feelings, and talents. Others can contribute to this piece by acting as muses and teachers knowledgeable about different techniques. These are the roles that I would have doctors, physical and psychological play. The goal is simply for the artist to continue contributing artwork to the community ... jrlewis

I really like some of the new platforms upon which people have been suggesting that we move forward. Taking more consideration for the individuality of each person, encouraging growth no matter where the patient is starting, and facilitating the ability to live up to potential ... However, I have one little bone to pick with these models. ... As healthcare providers we are defining, arbitrarily, where it is we want our patients to go ... What if, instead of adopting change and growth as the cornerstone of our new model of mental health, we adopted acceptance? .... instead of encouraging patients to push forward towards some arbitrarily defined goal or potential, we encourage them and help them to accept and find peace in their current condition ... change is an inherent characteristic of our brains. It's going to happen no matter what a patient or physician does. I wonder what would happen if patient and provider stepped back and allowed the change to happen on its own instead of trying to shape it into desired pathways ... ryan g

My definition of mental health – is a growing moment-to-moment awareness of the three loops (self-world, conscious-unconscious & intrapersonal) coupled with an ability to effectively integrate insight gained from the three loops into over-arching narratives – without sacrificing he constant access to new insight brought by moment-to-moment awareness.I also believe that compassion (love) for oneself and others is both a natural outgrowth of this type of awareness as well as a useful tool for achieving it ... adiflesher

asking someone to listen to their storyteller may be easier said than done and constructing a mental health system based on this notion overlooks the complex way that people understand themselves. So yes, from a perspective of a mental health professional it would be ideal to judge each case from a unique perspective with the interests of the patient as the number 1 priority. What happens though, when the interests of the patient are conflicting and unsure? When even they do not understand what it is they want ... akerle

it is this desire for control, and the ability to control, that really defines true mental health ... kgins

I agree that this definition (that health is individual etc) is probably the least wrong definition that we have come up with this semester, but I'm not sure if it helps our broken mental health system at all. If everyone is individual, how do you help them cost effectively? How do you know how to help them at all? How do you even know WHEN they need help? ... how can we change the current system to be able to work in this new paradigm? ... Ljones

I do think that there is that ultimate reality that we are all trying to explain. However, I don't think that that ultimate reality has an inherent set of meaning to it. I would say, it just exists and all meaning that is assigned to it is done by us ... I fully acknowledge that this is not a very useful set of thoughts for addressing issues such as healthcare policy and mental health parity. Also, as a future physician, I don't think it would be very good for business to go around telling my patients I don't actually believe there is any such thing as health. Because of this, I will definitely engage in learning and applying sets of meanings. Indeed, I plan on spending the next several years learning the version the AAMC wants me to learn ... ryan g

I think we need to put more money/effort/legislation into getting these ideas to be part of every child’s education. If everyone in the world could take this course, I think we could greatly decrease the need for therapists ... kmanning

Does it all then go back to the necessity of a cultural change, which changes how we view mental healthcare, so that it can become a dynamic continuum, part of an ongoing conversation, which incorporates "reciprocity" and which doesn't necessarily have a defined beginning and end, but one where better stories are constructed toward more productive and satisfying ends? ... mstokes


Meditation: Take off points

Definition of Vipassan meditation technique

"To see clearly; insight meditation; the simple and direct practice of moment-to-moment mindfulness. Through careful and sustained observation, we experience for ourselves the ever-changing flow of the mind/body process. This awareness leads us to accept more fully the pleasure and pain, fear and joy, sadness and happiness that life inevitably brings. As insight deepens, we develop greater equanimity and peace in the face of change, and wisdom and compassion increasingly become the guiding principles of our lives."

The power of the relaxation response

"Benson, of Harvard Medical School and the Benson-Henry Institute for Mind Body Medicine at Massachusetts General Hospital, discovered the relaxation response's power to reduce stress in the 1960s. But his subsequent research found that the approach is really no different from what people have done for centuries through prayer, chanting and repetitive motion.
Today, scientists have shown that such practices lower heart rates, blood pressure and oxygen consumption, and they alleviate the symptoms associated with a vast array of conditions, including hypertension, arthritis, insomnia, depression, infertility, cancer, anxiety, even aging."

Relaxation response can influence expression of stress-related genes

"Jeffery Dusek, PhD, co-lead author of the study notes, 'Changes in the activation of these same genes have previously been seen in conditions such as post-traumatic stress disorder; but the relaxation-response-associated changes were the opposite of stress-associated changes and were much more pronounced in the long-term practitioners.'"

Finding happiness: cajole our brain to lean to the left

"Indeed, Dr. Davidson has discovered what he believes is a quick way to index a person's typical mood range, by reading the baseline levels of activity in these right and left prefrontal areas. That ratio predicts daily moods with surprising accuracy. The more the ratio tilts to the right, the more unhappy or distressed a person tends to be, while the more activity to the left, the more happy and enthusiastic….
….Before the mindfulness training, the workers were on average tipped toward the right in the ratio for the emotional set point. At the same time, they complained of feeling highly stressed. After the training, however, on average their emotions ratio shifted leftward, toward the positive zone. Simultaneously, their moods improved; they reported feeling engaged again in their work, more energized and less anxious."

B.F. Skinner meets Buddha in DBT

"The actual skills taught in DBT groups are ancient and familiar. For example, mindfulness skills, which are versions of Eastern spiritual training, include observing, describing, participating in the here and now, taking a non-judgmental stance, focusing on one thing in the moment, and being effective. Clients learn the differences between three primary states of mind: "emotion mind," the "hot" state when emotions are in control; "reasonable mind," the cool, logical part of the mind that plans things; and "wise mind," which integrates the emotional and intellectual states and goes beyond them to include intuitive knowing. Ever validating, Dr. Linehan emphasizes that everybody has wise mind—it is that part of each person that can experience truth and know something in a centered way."

Comments

kgins's picture

Meditation

I thought the meditation we tried was really interesting.  The more conscious I became of my breath and my breathing, the faster I breathed.  I understand how this could be relaxing and freeing, but I began to wonder whether or not everyone actually has the ability to meditate.  I could focus on my breathing and nothing else, but even within the realm of breathing I thought that there was a lot to think about.  Is that "allowed"?  Or should the only focus be the concept of the air moving in one place, through another, and out a third?  Is it the breathing we're focusing on- however deep, shallow, quick, slow, loud, soft-- or the motion of the breathing, conceptualizing the air?  Does everyone naturally over think what seems to be such simple, basic instructions? Perhaps this suggests a pattern- I for one over think, and overanalyze more often than not- perhaps this is just the lens I come to see everything with, and perhaps we all enter each experience- such as meditation- with our own lens, which can help- or perhaps hinder- our meditation experience. Or, perhaps this overanalyzing is a protection mechanism to avoid the connection meditation can form?
vpizzini's picture

 "Insantiy is a human

 "Insantiy is a human condition. In us, insanity and reason exists and are  present together. The problem is that our society should accept insanity as much as reason, instead of instructing a science, psychiatry, to translate insanity into a disease  in order to eliminate it." (Franco Basaglia)

After the discussion, I thought that it may be interested to have this article on the blog. The system in Italy is very different, medical and mental treatments are covered by the state.

 

www.triestesalutementale.it/english/doc/psy_reform_act.doc 

Paul Grobstein's picture

mental health: PG thoughts 8 Dec session

Some notes of thoughts from Monday to mull further, for myself and anyone else interested ...

What are the differences among

  1. "undirected change"
  2. having a goal, moving toward it, learning from the experience in ways that might change not only how one moves but the goal itself
  3. having a goal, moving toward it, learning from the experience so as to become better at getting to the goal

Meditation is indeed a nice illustration of "how little control we have over our own minds." Do most people's minds/brains in fact alternate between "raging monologue" and being asleep? Certainly acquiring the ability to will a "relaxation response" is useful in a mental health context. But I think there is more at stake here, that meditation is one of several routes by which one can learn to recognize some measure of space between the cognitive unconscious and the story teller, and so to become less driven by not only external factors but internal ones as well, more able to influence one's own behavior.

The history of efforts to define and deal at a social/institutional level with mental health is one of those topics to which I think it would be useful to devote a lot more time. What particularly struck me on this occasion was the issue of "dehumanization," and its relation to "stigmatization." We are not yet, I think, entirely beyond thinking of people with mental health problems as less than fully human; "stigmatization" may simply be a more polite word for that. On the other hand, a broad view of history would suggest humans are getting somewhat better at not excluding people from the human community. And the recent parity legislation, imperfect as it may be, is certainly a movement in that direction in the contemporary US. Maybe that should be among the things on our list to improve mental health: to regard everybody as human, regardless of their variations?

Martin's picture

Undirected change is a

Undirected change is a contradiction in terms. The direction of change is always away from the original subject. A lack of a trend in that change might be called "undirected" but, that is not the same thing as "undirected change".  Change is always in some direction even if we don't know in which direction we are moving of if we are intentionally allowing ourselves to be moved by some other thing, (being passive or accpeting things).

Option 2 seems to me to be what most people in the world would like to do; to create the goal for themselves as they move along. As one changes, in any direction one likes, the goal or motive behind that change is altered to fit the new subject's desires. This allows for a nietzchean creation of the self, man is nothing but what he makes of himself/he is his acts/ the lightning is the flash of light. This I think is wrong.

Option 3 seems to me to be a perfectionism version of reality... that I like. We see the goal, as if through a mirror... darkly. We grope toward that goal, our vision of it becomes clearer. If we grope after some other goal our vision of the first goal becomes faded. By moving closer to the goal we change and become better able to see it and hopefully understand it.  But, I have doubts about our ability to communicate what we might see even if we were standing next to the goal... metaphorically speaking. 

I agree that stigmatization is another way of saying dehumanization. It is sad, and I think it is wrong and unhelpful. But, to draw a harsh comparrison between two large beurocracies: We can (even if we don't)  treat criminals like humans without disregarding their crimes. Likewise, we should be able to treat mentally ill people like humans without disregarding their affliction. To treat everybody the same, as if every human variation is equal, is lunacy.  All physical states are not created equal, nor are all mental states. Some people are healthier than others, some are stronger, some are weaker. Likwise some people good some are evil. Is it any one person's place to pass judgment on these things universally? No. But that is the position we are put in  each day with particular circumstances, i.e. should we help the criminal with the broken leg or the child with the broken leg? 

To call mental health the ability to grope around and make myself anew in my own image seems to me to be doomed to failure. We will not unite as one big happy human family, we will not accept eachother more as "individuals", and we will not respect our differences. If all that binds us together is our common behavior of recreating ourselves, all we will have in common is our own selfishness. That definition of mental health seems to me as though it will compound our problems. 

Sophie F's picture

There may well be

There may well be differences between three things you listed. However, they are not mutually exclusive and may form a Venn diagram, of sorts, (perhaps additional things can be added, too) to enable a person to engage in her own process of mental health. As one embarks/continues on the journey of mental health, if one begins with a premise of “undirected change” this might readily translate into a goal from which one may learn and need to again revisit or a goal that is unmet because it has shifted. I see these all as useful, not exclusively, but in conjunction with one another.

Enhancing agency, awareness and acceptance through meditation sounds great! How can these three “A’s” be enhanced in other ways?
Paul B's picture

Control over one's thoughts

"meditation is one of several routes by which one can learn to recognize some measure of space between the cognitive unconscious and the story teller, and so to become less driven by not only external factors but internal ones as well, more able to influence one's own behavior."

To hammer in that point...

Our thoughts directly affect how we feel. Hence, if we can control our thoughts, we can in turn control how we feel.

For example, a guy gives you a weird look. If you were to then think that this guy might be angry at you, you could consequently feel upset or worried. However, if you simply think to yourself "that guy gave me a weird look... oh well", then you could aviod the negative feelings.

In that respect, meditation is a great excerisize for controling one's thoughts and bettering one's mental health. By ignoring external and internal distractions, one could in turn learn how to ignore negative thoughts so we "become less driven by not only external factors but internal ones as well, more able to influence [our] own [feelings and] behavior"

ryan g's picture

Change and Mental Health

I'm still wrestling with the role of change in mental health.

 In regards to the scenarios that you laid out, part of me wants to reject the first one for reasons I was saying this past week.  It doesn't seem very useful to not define the direction of change.  However, going back to my acceptance idea... If that was the ideal and the focus of mental health was to be completely in the moment, content and at peace with the current conditions, change would still happen anyway, right?  Because of the nature of the brain.  If you or anyone else wasn't consciously trying to do anything to facilitate this change, then that would seem like undirected change to me.  Perhaps this is the realm for what is traditionally called faith in spiritual traditions.  

On the other hand, perhaps there just isn't any practical sense in trying to rule out change as a natural part of what we are trying to accomplish (as I was sort of trying to do with my whole acceptance kick).  In this sense, I think I like your second scenario for its flexibility.   

jrieders's picture

culture connection

When discussing whether physical and mental health should be considered equally important/insured someone brought up that mental health is less easy to define and changes from culture to culture, but ideas of physical health also differ from culture to culture. Public opinion on healthy weight/diet, smoking, hygiene, and even what one should do about more serious physical illnesses like diabetes, ulcers, and cancer vary across cultures. But we don't take this into account when considering whether physical illness should be insured, we are pretty stead fast in trusting our view of physical illness because there are all kinds of scientific experiements and facts backing this view. This is why I feel continued research is essential, even if it may lead to putting some people in boxes they don't feel they fit in, because more "facts" will lead to more funding, more research to finding less wrong boxes...
Paul Grobstein's picture

research and getting it less wrong

"more 'facts' will lead to more funding, more research to finding less wrong boxes"

Its a nice ideal, but sometimes the loop more "facts" and more research leads simply to "more 'facts" and more funding" without anyone actually getting less wrong, and sometimes even with people instead getting more wrong? Cf The pain may be real but the scan is deceiving.

Its an interesting question: can one say what kinds of "research" are more likely to contribute to getting less wrong?

jrieders's picture

true, but maybe if it

true, but maybe if it doesn't lead to getting it less wrong, it might lead to more legitamate and accessable/afforadable help and support for those looking for it.
Paul Grobstein's picture

Last mental health session (for now)

Thanks all for a rich and generative exporation of mental health, of education, and of the relation between them. Your thoughts from our last session go here. And, later, after time to think about the entire semester, your reflections go here. I'll certainly go on thinking about where we've gotten to in months/years to come. Drop me an email if you'd like to join a group to continue doing so next semester.

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